title: Home fortification with calcium reduces Hb response to iron among anaemic Bangladeshi infants consuming a new multi-micronutrient powder formulation.
abstract: OBJECTIVE
  To investigate whether the recommended dietary intake of Ca in anaemic infants compromises the expected Hb response, via home fortification with a new Ca- and Fe-containing Sprinkles™ micronutrient powder (MNP).
  
  
  METHODS
  A double-blind, randomized controlled, 2-month trial was conducted in Bangladesh. Infants were randomized to one of two MNP intervention groups containing Fe and other micronutrients, with or without Ca. Hb, anthropometrics and dietary intake were measured pre- and post-intervention while family demographics were collected at baseline.
  
  
  METHODS
  Twenty-six rural villages in the Kaliganj sub-district of Gazipur, Bangladesh.
  
  
  METHODS
  One hundred infants aged 6-11 months.
  
  
  RESULTS
  A significant increase in Hb (MNP, 13·3 (sd 12·6) g/l v. Ca-MNP, 7·6 (sd 11·6) g/l; P < 0·0001) was noted in infants from both groups. However, infants receiving MNP without Ca had a significantly higher end-point Hb concentration (P = 0·024) and rate of anaemia recovery (P = 0·008). Infants receiving MNP with Ca were more likely to remain anaemic (OR 3·2; 95 % CI 1·4, 7·5). Groups did not differ in dietary intake or demographic and anthropometric indicators.
  
  
  CONCLUSIONS
  Although both groups showed significant improvement in Hb status, the nutrient-nutrient interaction between Fe and Ca may have diminished the Hb response in infants receiving the Ca-containing MNP.
authors.affiliation: 1Department of Nutritional Sciences,University of Toronto,Toronto,Canada.
authors.forename: Waqas Ullah
authors.initials: WU
authors.lastname: Khan
authors.affiliation: 1Department of Nutritional Sciences,University of Toronto,Toronto,Canada.
authors.forename: Sohana
authors.initials: S
authors.lastname: Shafique
authors.affiliation: 3BRAC,Dhaka,Bangladesh.
authors.forename: Hasina
authors.initials: H
authors.lastname: Shikder
authors.affiliation: 1Department of Nutritional Sciences,University of Toronto,Toronto,Canada.
authors.forename: Yaseer Abdul
authors.initials: YA
authors.lastname: Shakur
authors.affiliation: 1Department of Nutritional Sciences,University of Toronto,Toronto,Canada.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Sellen
authors.affiliation: 3BRAC,Dhaka,Bangladesh.
authors.forename: Jalal S
authors.initials: JS
authors.lastname: Chowdhury
authors.affiliation: 1Department of Nutritional Sciences,University of Toronto,Toronto,Canada.
authors.forename: Stanley H
authors.initials: SH
authors.lastname: Zlotkin
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000178:diet therapy; D001459:Bangladesh; D002136:Calcium, Dietary / Q000009:adverse effects*; D004032:Diet; D004311:Double-Blind Method; D004347:Drug Interactions; D005527:Food, Fortified; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood / Q000627:therapeutic use*; D018673:Nutrition Policy; D012424:Rural Population; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D006454:Hemoglobins; D007501:Iron